The validity of nasal endoscopy in patients with chronic rhinosinusitis-An inter-rater agreement study

Background We evaluated the accuracy of nasal endoscopy in diagnosing chronic rhinosinusitis (CRS) compared with paranasal sinus computed tomography (CT). Methods Two authors independently searched the 5 databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database) up to March 2019. For all included studies, we calculated correlation coefficients between the endoscopic and CT scores. We extracted data on true-positive and false-positive and true-negative and false-negative results. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool (version 2). Results We included 16 observational or retrospective studies. A high correlation ( r = .8543; 95% confidence interval [CI] [0.7685–0.9401], P < .0001, I2 = 76.58%) between endoscopy and CT in terms of the diagnostic accuracy for CRS was apparent. The odds ratio (Lund–Kennedy endoscopic score ≥1) was 7.915 (95% CI [4.435–14.124]; I2 = 28.361%). The area under the summary receiver operating characteristic curve was 0.765. The sensitivity and specificity were 0.726 (95% CI [0.584–0.834]) and 0.767 (95% CI [0.685–0.849]), respectively. However, high interstudy heterogeneity was evident given the different endoscopic score thresholds used (Lund–Kennedy endoscopic score ≥1 vs 2). In a subgroup analysis of studies using a Lund–Kennedy endoscopic score threshold ≥2, the area under the summary curve was 0.881, and the sensitivity and specificity were 0.874 (95% CI [0.783–0.930]) and 0.793 (95% CI [0.366–0.962]), respectively. Conclusion Nasal endoscopy is a useful diagnostic tool; the Lund–Kennedy score was comparable with that of CT.

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Diagnostic Accuracy of Nasal Endoscopy as Compared to Computed Tomography in Chronic Rhinosinusitis

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-017-1232-0 ◽

2017 ◽

Vol 69 (4) ◽

pp. 494-499 ◽

Cited By ~ 7

Author(s):

Nitin V. Deosthale ◽

Sonali P. Khadakkar ◽

Vivek V. Harkare ◽

Priti R. Dhoke ◽

Kanchan S. Dhote ◽

...

Keyword(s):

Computed Tomography ◽

Diagnostic Accuracy ◽

Chronic Rhinosinusitis ◽

Nasal Endoscopy

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Nasal Endoscopy Billing Patterns: A Survey of the American Rhinologic Society

American Journal of Rhinology and Allergy ◽

10.1177/1945892418773570 ◽

2018 ◽

Vol 32 (4) ◽

pp. 330-336 ◽

Cited By ~ 2

Author(s):

Abtin Tabaee ◽

Charles A. Riley ◽

Seth M. Brown ◽

Edward D. McCoul

Keyword(s):

Chronic Rhinosinusitis ◽

Essential Element ◽

Nasal Endoscopy ◽

Web Based ◽

Significant Variability ◽

Clinical Scenarios ◽

History Of ◽

Coding Guidelines ◽

Training Practice

Introduction Nasal endoscopy (NE) is an essential element of office-based clinical rhinology, including the evaluation of chronic rhinosinusitis. Despite the presence of guidelines, variability exists regarding coding and billing for NE especially with regard to inclusion of evaluation and management (E&M) codes and use of the 25 modifier. The goal of this survey was to assess the billing patterns for NE among American Rhinologic Society (ARS) members. Methods An invitation to participate in a web-based survey was electronically sent to all ARS members. Survey participants were queried regarding demographics and billing patterns for NE in several different clinical scenarios using a 5-point Likert-type scale, with a score of 5 representing “always” and a score of 1 representing “never” for billing E&M. Results A total of 93 respondents successfully completed the survey with a range of the number of years since completing training, practice type (50.5% private, 44.1% academic) and completion of a rhinology fellowship (40.9%). Variable responses for billing patterns for distinct clinical scenarios were noted. Higher scores for billing both E&M and NE for the queried clinical scenarios were noted for new patients (mean 4.50) compared to established patients (mean 3.81) and postoperative patients (mean 3.04). Inclusion of a septoplasty as part of the surgery impacted billing an E&M code 28% of the time. Practice type and history of performing a fellowship did not significantly influence billing patterns for NE. Conclusions Significant variability exists among ARS respondents with regard to billing patterns for NE, despite the presence of coding guidelines. Additional teaching of standard coding practices for NE may limit variability among otolaryngologists.

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Diagnosis of Adult Chronic Rhinosinusitis: Can Nasal Endoscopy Predict Intrasinus Disease?

Oman Medical Journal ◽

10.5001/omj.2013.120 ◽

2013 ◽

Vol 28 (6) ◽

pp. 427-431 ◽

Cited By ~ 4

Author(s):

Arif Ali Kolethekkat ◽

Roshna Rose Paul ◽

Mary Kurien ◽

Shyam Kumar ◽

Rashid Al Abri ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Nasal Endoscopy

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Evaluating vestibular schwannoma size and volume on magnetic resonance imaging: An inter- and intra-rater agreement study

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2016.04.010 ◽

2016 ◽

Vol 145 ◽

pp. 68-73 ◽

Cited By ~ 13

Author(s):

Anna C. Lawson McLean ◽

Aaron Lawson McLean ◽

Steffen K. Rosahl

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Vestibular Schwannoma ◽

Rater Agreement ◽

Resonance Imaging ◽

Agreement Study

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Evaluation of the medical and surgical management of chronic rhinosinusitis with polyposis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20161595 ◽

2016 ◽

Author(s):

Neetu Modgil

Keyword(s):

Medical Treatment ◽

Chronic Rhinosinusitis ◽

Nasal Polyposis ◽

Visual Analogue Score ◽

Nasal Endoscopy ◽

Polyp Size ◽

Effective Measure ◽

Continue Medical ◽

Saccharine Test

Background: Chronic rhinosinusitis (CRS) is a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 consecutive weeks duration. Surgical intervention may be required if severe symptoms of obstruction and infection prove medical treatment to be ineffective. Little is known about the outcomes of patients electing to continue medical management or the comparative effectiveness of continued medical therapy with FESS.Methods: The study was conducted on 126 adult patients in the age group of 18-55 who fulfilled the CRS criteria with nasal polyposis. All patients were medically treated for the CRS, and observed after 3 weeks. In case the treatment was not effective; they were scheduled for FESS intervention and further observed after another 6 weeks. The improvement of the patients was measured by Visual analogue score, nasal endoscopy score and saccharine test. Results: Males between 41-50 were the most common patients with CRS. There was a significant improvement in the VAS score, nasal endoscopy score after 3 weeks of medical treatment. In 88% of patients the saccharine score was normal showing that this was not an effective measure for assessing the improvement.Conclusions: Medical treatment was found to be sufficient to treat most symptoms of CRS with nasal polyposis (grade 1 and 2). Surgery should only be done in refractory cases. Selection of those patients who will benefit from surgery should be based on the patient’s symptoms and not on the examiner’s polyp score. Quality of life is not proportional to polyp size (Upto grade 2).

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